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Wednesday, March 09, 2011

the remains of the day

My teeming garbage can after doing eight straight back-to-back cases at one of our outpatient surgical centers today. I know basically everything in the hospital is one use only and sterilely packaged these days, but this was my giant, industrial-sized garbage can after just one day in the OR. What happens to all this garbage anyway?

(This is the part where someone smart in the comments section answers that question, and then I get super depressed. An inconvenient truth indeed.)

19 comments:

A month or so ago, an OR scrub nurse and I were chatting about how medical supply manufacturers ought to make some of the stuff reusable or, at the least, recyclable. I doubt it'll happen, since manufacturers make more by selling more(obviously) and a reusable item is a one time sale(until the item breaks).

But what if the hospitals were to start demanding more reusable products as a way to cut costs? Patients ought to demand more reusable goods as it could save them money too. Ahh, it's fun to dream.

Ugh - I absolutely HATE thinking about how much waste hospitals/medical centers create. It's really scary. During my first year of med school, I followed an ID specialist around the hospital for a few days. There was a whole team of people with him, and ALL of us had to gown & glove in about 60% of the rooms we went in . . . including me and the two 3rd years on his service. We stood in the room for less than five minutes most of the time and most of us weren't even close enough to touch ANYTHING . . . and then we would de-robe en mass and toss everything in the garbage. UGH!

I think medicine in general wastes a lot. I posted this picture on my blog (http://redstethoscope.blogspot.com/2011/01/just-little-light-pharmacology-reading.html), in January, of the Pharm. notebook a friend lent me to study. Multiply that by four or five and you know how much paper my med. school uses per student, per semester. We rationalize it to ourselves that it's a necessary evil and ultimately, we are going to help people by what we learn, but it's still disturbing.

I know it's a lot of waste, but I'm actually glad that so many things are thrown away after one use. Prions aren't destroyed by heat-sterilization, which is the only thing that many hospitals use on surgical tools between surgeries, so the reuse of things like scalpels can actually spread things like mad cow disease and fatal familial insomnia when the patients aren't diagnosed ahead of time. If hospitals started routinely using heat AND chemical sterilization, I'd be all for reusable products. Until then, no matter how uncommon prion diseases are, I'd rather be safe than green.

"You may not know this, but hospitals are among the most environmentally unfriendly places on the entire planet. In the United States, hospitals account for 8% of the entire country, On this side of the border, just one hospital in Vancouver has an ecological footprint nearly 740 times its physical size. Health care has lagged behind when it comes to going green one good reason - your safety. Trouble is, the double-gloving and triple packaging we do to protect your health is also killing the environment."

our hospital has gone from re-sterilising things like bowls and linen to using disposable because it is cheaper for them to buy multiple bundles (we do 100+ operations/day) then sterilise metal bowls and green linen that many times.

and, I also have to wonder if the extra energy expenditure needed to run the machines to sterilize everything would be just as bad, or worse, than using disposable. definitely it would jack the cost up (as anon 8:57 pointed out).

maybe hospitals should stick with disposables but just get a lot better at recycling instead of mass-dumping.

I think it'd be great if the packaging material manufactures use become biodegradable, and as 101MD said, recycled better.

I do think biodegradable packaging may cause issues people with corn allergies, since may of the biodegradable materials currently are corn-derived... but I guess for those with known corn sensitivity, the hospital would just use non=biodegradable packaged stuff.

I'm def in the group of 'I'd rather the hospital use one-time-use stuff on me.' I work with medical device companies, I look at how some of the multi-use instruments are designed and see where bunch of buggers can hide out and that creeps me out to put it lightly...

UGH, I work on Infectious Diseases floor. We have two beds a room. Housekeeping comes and changes the trash twice a day. It's not uncommon for us to have to call them early or extra at times! The trash cans get chocked full of yellow disposable isolation gowns. We used to have linen ones, but I guess the laundry fee was too high. I also toss out 1 L bottles of sterile water that are opened once they past 24hrs and get new ones... And we use a lot! One for the GT, and one for suctioning.

I find the dichotomy between patient safety and the environment a bit dubious. After all all this waste has health implications, from the antibiotics and hormones in our water all the way up. We just don't understand the impacts as well because they don't lend themselves to easy measurement and there is little commercial reason to research them out. More and more of the research pie is being funded by commercial parties.

Perhaps the real dichotomy isn't "patient safety vs. environment" but rather "short-term patient well being vs. long-term public health". How much harm are we willing to do to the long-term health of our community and future generations in order to avoid one prion infection?

Why are we willing to pay (as a society) so much more to prevent prion infections than to reduce traffic deaths?